Thursday, August 11, 2011

The Israeli-Palestinian conflict is obviously a hot-button issue. And I'm not taking sides, nor am I proposing a solution. If you think this yak herder can help, you've come to the wrong place.

But here's where it affects me:

There's a Parkinson's Disease medication called Azilect. It has some unique properties, and there's no generic, or direct competitors, currently available. It's manufactured by Teva, a company that does most of their business in generic drugs. It's the world's largest generic drug manufacturer, and if you've taken ANY type of pill at some point in your life, the odds are you've used a Teva product.

Teva is an Israeli company. I personally don't care. From my view, they make a useful drug, and if I think you could benefit from it, I'll write for it.

Most people are fine with this. But I always get a handful of calls a year from people refusing to take it, or calling to yell at me, for prescribing an Israeli product. Some refuse to take it because they don't want to support Israel. Others have accused me of secretly prescribing it over other drugs as part of some vast Israeli conspiracy. I've even had one patient fire me because I wrote for it.

Here's the bottom line people: I don't care where your medication was made, who makes it, or the name of the chemist in the assembly line.

I am your doctor, and when you're here, my goal is to try and make you better. I'm not getting kickbacks for these scripts, nor are they my way of making a political statement.

Improving you is what I'm trying to do. So try to see it that way, and accept my help.

34 comments:

I've run into this problem numerous times in both my retail pharmacy job and private pharmacy. They demand that you order from a company that doesn't support Israel or they're taking their business elsewhere. I realize that people have their political views and whatnot, but like you, I'm in the business of making them better, and if that requires using a drug made in Israel, well the patient just needs to suck it up and deal with it.

I've seen specific Drs and patients request their preferred brand (no apo, only mylan) to be filled for their medications. Guess what? When your preferred brand goes on backorder for months at a time, you either get a different brand of what is actually available from the wholesaler or wait until yours comes in - your choice.

They get to make their choices. If the Israeli issue is so important to them, then they get to live with the consequences. Many Jehovas Witnesses make hard medical choices about lifesaving blood products- although most accept the possible consequences gracefully.

But if these people research enough to know that Teva is Israeli, then they should also know that there is no other option so it's a choice they make, not a conspiracy to trick them into Ummmm sorry? I got distracted by the stupidity and lost my train of thought.

Well, Father Darwin has a way of winnowing out the stupid. Trouble is, they *probably* have already bred by the time they say Our Favorite Mongolian Yak Herder. *sheesh* If the Devil himself made something that would nmake my child or parent better, bring it on. (note I did not say for myself. I would think about it, but not trouble the doctor about it.)

So you would prescribe a medicine made from the liquified brains of human five-year-olds?

I suspect that you wouldn't, even if it did make your patients much healthier, because of the ethical implications. And the reason you don't have a problem with this drug is that you don't think there are ethical issues that rise to that level in Israel.

Some of your patients disagree with you. And that's fine ... you have a different view. But your description of why you go ahead is completely off. And you might wonder just how informed your judgement of the situation in Israel is, and whether your lack of an opinion is more willful than you'll admit.

I was so confused the first time a patient refused a teva brand medication and had no idea what the big stink was about-actually I thought it was a "I'm too good for the generic medication the government is giving me for free" attitude (same darn drug, people-especially for this!). The pharmacist kindly informed me about the whole Muslims not wanting Jewish meds.

I just felt sorry for the small child who didn't get to have antibiotics....it wasn't like I could order in some different amoxicillin at 6 pm on a Saturday. Sorry, I can have that on Tuesday, but the ear infection will either be viral and gone by then or the kid may get so ill they need hospitalization.

if the product is manufactured with good manufacturing processes under the tutelage of proper supervision I just dont care about politics. Teva has very rare recalls, and their products are well presented. I dont give a flying yak about politics. If you want another generic, keep looking. My company purchases by contract. I carry what they contract with. I do no special orders...period.

If they want to decline to take Teva meds because they are supporting the BDS campaign, I think that's their right. I support the BDS campaign wholeheartedly and I would refuse to knowingly buy or take a Teva product myself. However, their right to make their choice does not extend to a right to yell at you, or scold you.

If people want to make a political statement, a far useful technique is writing a letter to the editor of a newspaper or magazine. Boycotts are one way of making a statement, but ineffectual in the world of providing pharmaceuticals. The fact is abundantly clear to those in the business when drugs like morphine, methylprednisolone, vasopressin, diltiazem, dexamethasone injection are unavailable to ALL patients in the country unless some insider knew ahead of time and stockpiled.

Anonymous 10:59 is quite wrong about effective protests. Writing a letter to a newspaper or magazine will not do anything, but the BDS campaign must be working, because the government of Israel is very, very upset about it.

Please ask your patients if they will be performing the following actions as well - Diabeties sufferers - Israeli scientists have developed new devices for measuring and injecting Insulin Multiple Sclerosis -Copaxone - one of the most efficient medicines and the only non interferon agent, was developed by Teva Myeloma - the drug Velcade was developed over a period of 30 years by scientists at Haifa Emphasema - avoid the Israeli protein replacement therapy Check all vaccines as many of these have been developed in Israel. Ensure that all X-rays do carry a radiation risk, as the only radiation-free system is Israeli Ensure any colonoscopy or gastro investigation does not use internal Israeli cameras such as the Pillcam. Do not protect babies and infants from Sudden Infant Death Syndrome with the Babysense system from Israel. Do not undergo surgery to install an artificial heart, as the first artificial heart transplant took place in Israel. Sufferers of Parkinsons must avoid the brain pacemaker - pioneered in Israel to stop tremors. Also Levodopa to reduce motor disturbances. Or magnetic cortex stimulation Do not take any form of medication to combat cancer. Israeli scientists have been developing treatments in this area for decades. Kidney transplants must only use kidneys from donors of the same blood group. Israel's revolutionary new methods allow donors from other blood groups. Treatments derived from Stem Cell research must be avoided as most of this is Israeli-developed If you or your family are struck with a bacteria infection, do not take alternatives to older, ineffective bacteria-resistant antibiotics as an Israeli discovery will have been responsible for the modern, effective drugs. Epileptics must avoid any treatment that may have benefited from the Israeli discovery of the underlying mutant gene.• Check that any pain relief medication is not based on soya as an Israeli doctor discovered the beneficial effect of the soya bean. Before any surgery or medical tests, check that hospital catheters have not been protected from infection using the new plastic from Israel that disables micro-organisms •Sufferers of sleep apnea must avoid tests using the breakthrough Israeli device for diagnosis.• Any incident of stroke or head trauma or onset of Alzheimer’s, Parkinson’s, MS, epilepsy, glaucoma or brain tumour must avoid using any of the Weizmann Institute's patented methods of treatment. Do not use the revolutionary new Israeli bandage that saved Arizona senator Gabriella Giffords after she was shot in the head. •

Obviously way, way late on this but high five to the last commenter. I think those same people refusing Teva manufactured drugs would be dumbfounded if they ever realized how many big medical breakthroughs happen in Israel and how much Israel has contributed to medicine, science, technology, etc. if something can help make your life better (or even SAVE YOUR LIFE as is sometimes the case with meds) who the heck cares about politics? Politics shouldn't even have a place when we're talking about helping people get better, saving their lives, or even just improving their quality of life in terms of a chronic disease.

I get that sometimes we do have options even then. Heck, as a kosher keeping Jew (well no more exactly, though I assume being TPN dependent means it doesn't matter) before I became sick with very severe rare neuro/ GI illnesses that left me with no choice in what I took (which is the whole point, why refuse a drug made in Israel if it's the only option you have? I'd probably knowing take a drug knowingly made by a group of anti-Semitic drug makers, if they existed, and said drug might allow me a better quality of life or even to eat food again!) anyway, back when I did have a choice my Muslim PCP and I got along swimmingly and because she was an observant Muslim who avoided pork products she knew when and how to write for non-gelatin or capsule varieties of meds and I thought she was awesome! Ironically enough, if one is wanting to get non-gelatin/ pork free antibiotics, u know who makes them? Yep, Teva. So the irony then is that both Muslims and Jews who follow dietary laws actually have a shared interest in the brand. Now if only we could shake hands and say "I don't eat pig, you don't eat pig. We're not so different and even share common interests and both want to be healthy too. The end." and as for others who get in on these debates... Well, let's not get political. In the end though, when we're sick we all want the same thing, no matter our politics, or religion, etc, etc. We just want to get better. and maybe some illnesses afford you options, but there are so many rare diseases where you're lucky to have even one drug that only has a slim chance of helping anyhow. My mind would be loan if someone refused it over an issue like this that quite bluntly, doesn't really effect any of our lives personally (from a US point of view)

But bah, off my soapbox. I've been reading through your blog after finding it several days ago. Loving it. :)

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